<?php
$z[0]=Array("php","\r\n\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '<p><span></span>爱尔尽忱自闭症申请表预览</p>';\r\n\r\n                        } else {\r\n                            echo '<p><span></span>爱尔启明星申请表预览</p>';\r\n                        }\r\n                        ",5712,6118);
$z[1]=Array("field","",6406,6422);
$z[1][4]['name']="id";
$z[2]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '<p class=\"title\">“爱尔尽忱自闭症工程”</p>';\r\n\r\n                        } else {\r\n                            echo '<p class=\"title\">“爱尔启明星工程”</p>';\r\n                        }\r\n                        ",6707,7107);
$z[3]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '<li class=\"lb\">类别：爱尔尽忱</li><br>';\r\n\r\n                        } else {\r\n                            echo '<li class=\"lb\">类别：启明星工程</li><br>';\r\n                        }\r\n                        ",7253,7644);
$z[4]=Array("field","",7819,7838);
$z[4][4]['name']="title";
$z[5]=Array("field","",7871,7892);
$z[5][4]['name']="xingbie";
$z[6]=Array("field","",7966,8021);
$z[6][4]['name']="chushengriqi";
$z[6][4]['function']="MyDate('Y-m-d',@me)";
$z[7]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n\r\n                        } else {\r\n                            echo '民族：<span class=\"xb\">'.\$refObj->Fields['jianhurenqianzi'].'</span>';\r\n                        }\r\n                        ",8054,8381);
$z[8]=Array("field","",8522,8546);
$z[8][4]['name']="hujizhuzhi";
$z[9]=Array("field","",8628,8655);
$z[9][4]['name']="jianhurenname";
$z[10]=Array("field","",8697,8717);
$z[10][4]['name']="guanxi";
$z[11]=Array("field","",8803,8832);
$z[11][4]['name']="jianhurenlianxi";
$z[12]=Array("field","",8935,8981);
$z[12][4]['name']="pubdate";
$z[12][4]['function']="MyDate('Y',@me)";
$z[13]=Array("field","",9008,9054);
$z[13][4]['name']="pubdate";
$z[13][4]['function']="MyDate('m',@me)";
$z[14]=Array("field","",9080,9126);
$z[14][4]['name']="pubdate";
$z[14][4]['function']="MyDate('d',@me)";
$z[15]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            echo '<div class=\"sqzyz-body sqzyz-body2\">\r\n                    <div>\r\n                        1、救助对象 </div>\r\n                    <div>\r\n                        &nbsp; &nbsp;家中双胞胎被诊断为自闭症/家中有2名及以上自闭症患儿</div>\r\n                    <div>\r\n                        2、救助年龄</div>\r\n                    <div>\r\n                        &nbsp; &nbsp;2岁-8岁</div>\r\n                    <div>\r\n                        3、救助病种</div>\r\n                    <div>\r\n                        &nbsp; &nbsp;孤独症谱系障碍（在二甲及以上医院已确诊）。</div>\r\n                    <div>\r\n                        4、救助金额标准</div>\r\n                    <div>\r\n                        &nbsp; &nbsp;4000元/组，用于支持患儿日常康复、生活补贴</div>\r\n\r\n                    <div>\r\n                        5、患儿的所有申报资料由其法定监护人负责填报，并保证所有资料的真实性和完整性。如申报资料中出现的虚假、伪造或隐瞒等情况，一经发现，将不予救助。已经接受项目救助的，将追索其所获得的全部救助，情节严重者将对之采取行政或法律手段进行诉讼。\r\n                    </div>\r\n                    <div>\r\n                        6、得到项目救助的患儿监护人有责任和义务提供必要的反馈材料和照片等，在维护患儿权益前提下同意使用照片、录像等资料用于公益目的宣传；</div>\r\n                    <div>\r\n                        7、在申请救助期间如家长提出不再申请救助的，本申请文件即刻作废，并由“爱尔尽忱自闭症”项目办公室统一销毁；</div>\r\n                    <div>\r\n                        8、本申请表由北京爱尔公益基金会“爱尔尽忱自闭症”项目办公室负责解释。</div>\r\n                    <div>\r\n                        &nbsp;</div>\r\n                    <div>\r\n                        我确认已经阅读了以上全部条款，并同意所有申请规定。</div>\r\n                    <br>\r\n                    <br>\r\n                    <br>\r\n                    <div class=\"qz\" style=\"text-align: right;\">\r\n                        患儿监护人签字：<br>\r\n                        &nbsp;</div>\r\n                    <div class=\"rq\" style=\"text-align: right;\">\r\n                        年 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;月 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;日&nbsp;</div>\r\n\r\n                </div>';\r\n\r\n                        } else {\r\n                            echo '<div class=\"sqzyz-body sqzyz-body2\">\r\n                    <div>\r\n                        1、救助对象</div>\r\n                    <div>\r\n                        （1）在“启明星工程”康复基地开展康复的2-7岁患儿。</div>\r\n                    <div>\r\n                        （2）军、烈属家庭的患儿优先救助。</div>\r\n\r\n                    <div>\r\n                        2、救助病种</div>\r\n                    <div>\r\n                        孤独症谱系障碍（在二甲及以上医院已确诊）。</div>\r\n                    <div>\r\n                        3、救助金额标准</div>\r\n                    <div>\r\n                        1万元/人/年，用于患儿及家庭日常生活补贴</div>\r\n                    <div>\r\n                        4、患儿的所有申报资料由其法定监护人负责填报，并保证所有资料的真实性和完整性。如申报资料中出现的虚假、伪造或隐瞒等情况，一经发现，将不予救助。已经接受项目救助的，将追索其所获得的全部救助，情节严重者将对之采取行政或法律手段进行诉讼。\r\n                    </div>\r\n                    <div>\r\n                        5、申请表的递交并不代表已经获准得项目救助，申报资料的审核和审批工作由北京爱尔公益基金会“启明星工程”项目办公室负责。</div>\r\n                    <div>\r\n                        6、得到项目救助的患儿监护人有责任和义务提供必要的反馈材料和照片等，在维护患儿权益前提下同意使用照片、录像等资料用于公益目的宣传；</div>\r\n                    <div>\r\n                        7、在申请救助期间如家长提出不再申请救助的，本申请文件即刻作废，并由“启明星工程”项目办公室统一销毁；</div>\r\n                    <div>\r\n                        8、本申请表由北京爱尔公益基金会“启明星工程”项目办公室负责解释。</div>\r\n                    <div>\r\n                        &nbsp;</div>\r\n                    <div>\r\n                        我确认已经阅读了以上全部条款，并同意所有申请规定</div>\r\n                    <br />\r\n                    <br />\r\n                    <br />\r\n                    <div class=\"qz\" style=\"text-align: right;\">\r\n                        患儿监护人签字：<br />\r\n                        &nbsp;</div>\r\n                    <div class=\"rq\" style=\"text-align: right;\">\r\n                        年&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;月&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;日&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;\r\n                    </div>\r\n\r\n                </div>';\r\n                        }\r\n                ",9444,14946);
$z[16]=Array("field","",15614,15664);
$z[16][4]['name']="pubdate";
$z[16][4]['function']="MyDate('Y-m-d',@me)";
$z[17]=Array("field","",15778,15794);
$z[17][4]['name']="id";
$z[18]=Array("php","\r\n						if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n						    \r\n						        echo '<td width=\"133px\" height=\"6px\">患儿1姓名</td>';\r\n						\r\n						} else {\r\n						    echo '<td width=\"133px\" height=\"6px\">患儿姓名</td>';\r\n						}\r\n						",15948,16223);
$z[19]=Array("field","",16293,16312);
$z[19][4]['name']="title";
$z[20]=Array("field","",16422,16478);
$z[20][4]['name']="chushengriqi";
$z[20][4]['function']="MyDate('Y-m-d',@me)";
$z[21]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '<td width=\"133px\" rowspan=\"3\" colspan=\"2\"></td>';\r\n\r\n                        } else {\r\n                            echo '<td width=\"133px\" rowspan=\"4\" colspan=\"2\"></td>';\r\n                        }\r\n                        ",16511,16903);
$z[22]=Array("field","",17081,17102);
$z[22][4]['name']="xingbie";
$z[23]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '<td width=\"133px\">确诊年龄</td>\r\n                        <td width=\"133px\">'.\$refObj->Fields['quezhengnianling'].'</td>';\r\n\r\n                        } else {\r\n                            echo '<td width=\"133px\">民族</td>\r\n                            <td width=\"133px\">'.\$refObj->Fields['jianhurenqianzi'].'</td>';\r\n                        }\r\n                        ",17133,17674);
$z[24]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            \r\n                                echo '\r\n                        <td width=\"120\">身份证号</td>\r\n                        <td >'.\$refObj->Fields['huanerno'].'</td>\r\n                    ';\r\n                        } else {\r\n                             echo '<td width=\"133px\">确诊年龄</td>\r\n                            <td width=\"133px\">'.\$refObj->Fields['quezhengnianling'].'</td>';\r\n                        }\r\n                        ",17779,18351);
$z[25]=Array("field","",18493,18519);
$z[25][4]['name']="sn_canji_rad";
$z[26]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                        \r\n                        } else {\r\n                             echo '<tr>\r\n                        <td width=\"120\">身份证号</td>\r\n                        <td colspan=\"3\">'.\$refObj->Fields['huanerno'].'</td>\r\n                    </tr>';\r\n                        }\r\n                        \r\n                        ",18573,19018);
$z[27]=Array("php","\r\n\r\nif (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n   echo ' <tr width=\"100%\">\r\n                        <td width=\"133px\" height=\"6px\">患儿2姓名</td>\r\n                        <td width=\"133px\">'.\$refObj->Fields['title2'].'</td>\r\n                        <td width=\"133px\">出生年月</td>\r\n                        <td width=\"133px\">'.date('Y-m-d',\$refObj->Fields['chushengriqi2']).'</td>\r\n\r\n                        <td width=\"133px\" rowspan=\"3\" colspan=\"2\"></td>\r\n                        \r\n                    </tr>\r\n                    <tr>\r\n                        <td width=\"133px\">姓别</td>\r\n                        <td width=\"133px\">'.\$refObj->Fields['xingbie2'].'</td>\r\n                       <td width=\"133px\">确诊年龄</td>\r\n                        <td width=\"133px\">'.\$refObj->Fields['quezhengnianling2'].'</td>\r\n                        \r\n                    </tr>\r\n                    <tr>\r\n                            \r\n                       \r\n                        <td width=\"120\">身份证号</td>\r\n                        <td >'.\$refObj->Fields['huanerno2'].'</td>\r\n\r\n                        \r\n                        <td width=\"133px\">是否办理残疾证</td>\r\n                        <td width=\"133px\">'.\$refObj->Fields['sn_canji_rad2'].'</td>\r\n                    </tr>';\r\n\r\n}\r\n",19050,20387);
$z[28]=Array("field","",20575,20599);
$z[28][4]['name']="hujizhuzhi";
$z[29]=Array("field","",20855,20879);
$z[29][4]['name']="sn_bank_id";
$z[30]=Array("field","",20998,21024);
$z[30][4]['name']="sn_bank_name";
$z[31]=Array("field","",21182,21208);
$z[31][4]['name']="sn_bank_hang";
$z[32]=Array("field","",21694,21721);
$z[32][4]['name']="jianhurenname";
$z[33]=Array("field","",21770,21790);
$z[33][4]['name']="guanxi";
$z[34]=Array("field","",21851,21878);
$z[34][4]['name']="jianhurenshno";
$z[35]=Array("field","",21927,21956);
$z[35][4]['name']="jianhurenlianxi";
$z[36]=Array("field","",22387,22414);
$z[36][4]['name']="jinjirenname1";
$z[37]=Array("field","",22463,22492);
$z[37][4]['name']="jinjiren1guanxi";
$z[38]=Array("field","",22553,22582);
$z[38][4]['name']="jinjiren1lianxi";
$z[39]=Array("field","",22643,22673);
$z[39][4]['name']="jinjiren1lianxi2";
$z[40]=Array("field","",22775,22798);
$z[40][4]['name']="jinjiren2";
$z[41]=Array("field","",22847,22873);
$z[41][4]['name']="jinji2guanxi";
$z[42]=Array("field","",22934,22960);
$z[42][4]['name']="jinji2lianxi";
$z[43]=Array("field","",23021,23048);
$z[43][4]['name']="jinji2lianxi2";
$z[44]=Array("php","\r\n        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n        \r\n        } else {\r\n             echo '<tr>\r\n                        <td width=\"133px\" rowspan=\"2\">康复情况</td>\r\n                        <td width=\"133px\" colspan=\"2\">康复机构</td>\r\n                        <td width=\"133px\" colspan=\"3\">康复时间</td>\r\n                    </tr>\r\n                    <tr>\r\n                        <td width=\"133px\" colspan=\"2\">'.\$refObj->Fields['kangfujigou1'].'</td>\r\n                        <!-- <td width=\"133px\" colspan=\"3\">'.date('Y-m-d',\$refObj->Fields['zhiliao1']).'</td> -->\r\n						<td width=\"133px\" colspan=\"3\">自'.date('Y-m-d',\$refObj->Fields['kangfu1shijian']).'至'.date('Y-m-d',\$refObj->Fields['kfjs1']).'</td>\r\n                    </tr>';\r\n        }\r\n      \r\n\r\n\r\n",23102,23917);
$z[45]=Array("php","\r\n        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                echo '<tr>\r\n    <td width=\"120\" rowspan=\"3\">康复情况</td>\r\n    <td width=\"290\">姓名</td>\r\n    <td width=\"290\" colspan=\"1\">康复机构</td>\r\n    <td width=\"290\" colspan=\"3\">康复时间</td>\r\n\r\n</tr>\r\n<tr>\r\n\r\n    <td width=\"290\">'.\$refObj->Fields['kangfuname'].'</td>\r\n    <td width=\"290\">'.\$refObj->Fields['kangfujigou1'].'</td>\r\n    <td width=\"290\" colspan=\"3\">自'.date('Y-m-d',\$refObj->Fields['kangfu1shijian']).'至'.date('Y-m-d',\$refObj->Fields['kfjs1']).'</td>\r\n\r\n</tr>\r\n<tr>\r\n\r\n    <td width=\"290\">'.\$refObj->Fields['kangfuname2'].'</td>\r\n    <td width=\"290\">'.\$refObj->Fields['kangfujigou2'].'</td>\r\n    <td width=\"290\" colspan=\"3\">自'.date('Y-m-d',\$refObj->Fields['kangfushijian2']).'至'.date('Y-m-d',\$refObj->Fields['kfjs2']).'</td>\r\n\r\n</tr>';\r\n        \r\n        } else {\r\n             \r\n        }\r\n      \r\n         \r\n\r\n",23958,24898);
$z[46]=Array("field","",25464,25514);
$z[46][4]['name']="pubdate";
$z[46][4]['function']="MyDate('Y-m-d',@me)";
$z[47]=Array("field","",25628,25644);
$z[47][4]['name']="id";
$z[48]=Array("field","",26389,26410);
$z[48][4]['name']="jianshu";
$z[49]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            echo '居/村委会家庭情况真实性核查意见';\r\n                            \r\n\r\n                        } else {\r\n                            echo '市残联审核意见';\r\n                        }\r\n                ",27066,27419);
$z[50]=Array("field","",30219,30238);
$z[50][4]['name']="hrsfz";
$z[51]=Array("field","",30546,30572);
$z[51][4]['name']="sn_canji_img";
$z[52]=Array("field","",30885,30906);
$z[52][4]['name']="jhrsqz1";
$z[53]=Array("field","",30952,30972);
$z[53][4]['name']="jhrhkb";
$z[54]=Array("field","",31294,31323);
$z[54][4]['name']="sn_zhenduan_img";
$z[55]=Array("php","\r\n                        if (\$refObj->Fields['sn_qmx_jz'] == '爱尔尽忱'){\r\n                            echo '单位：北京爱尔公益基金会“爱尔尽忱自闭症”项目办公室<br>';\r\n                            \r\n\r\n                        } else {\r\n                            echo '单位：北京爱尔公益基金会“启明星工程”项目办公室<br>';\r\n                        }\r\n                ",31473,31917);
$z[56]=Array("field","",35497,35513);
$z[56][4]['name']="id";

?>